California Workers' Comp Claims Examiner — Flexible Schedule

Sedgwick; Roseville (CA); On-site; USD 80,000 - 100,000; Full time

Benefits offered by this job

Flexible schedule

Career development

401K on day one

Medical benefits

Dental benefits

Vision benefits

Job summary

Sedgwick in Roseville, CA is seeking a Claims Examiner specialized in California workers' compensation to analyze complex claims, determine benefits, and manage high-exposure cases.

You will adjudicate, negotiate settlements, and coordinate with litigations while upholding client service standards and regulatory requirements. This role offers growth opportunities within a global leader.

Qualifications

• Bachelor's degree from an accredited college or university preferred.
• Five (5) years of workers' compensation claims management experience or equivalent combination of education and experience required.
• California jurisdictional knowledge required; SIP required or must be obtained within one year of hire date.

Responsibilities

• Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine exposure; manages claims to timely resolution.
• Negotiates settlement of claims within designated authority.
• Calculates and assigns reserves to claims; manages reserve adequacy.
• Calculates and pays benefits due; approves and makes timely claim payments and adjustments; settles claims within authority.
• Prepares necessary state filings within statutory limits.
• Manages the litigation process; ensures timely and cost effective claims resolution.
• Reports claims to the excess carrier and responds to directions in a professional and timely manner.

Skills

Workers' compensation experience

Litigation knowledge

Investigation

Settlement negotiation

Analytical thinking

Education

Bachelor's degree

Job description

Sedgwick in Roseville, CA is seeking a Claims Examiner specialized in California workers' compensation to analyze complex claims, determine benefits, and manage high-exposure cases.

You will adjudicate, negotiate settlements, and coordinate with litigations while upholding client service standards and regulatory requirements. This role offers growth opportunities within a global leader.